Provider Demographics
NPI:1760197834
Name:MCNEIL, TAMERA YVETTE (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:TAMERA
Middle Name:YVETTE
Last Name:MCNEIL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 BLUE CYPRESS WAY
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-2307
Mailing Address - Country:US
Mailing Address - Phone:510-334-9122
Mailing Address - Fax:
Practice Address - Street 1:2765 MITCHELL DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-1601
Practice Address - Country:US
Practice Address - Phone:925-448-3782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24574225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation